Introduction

Mifos X is a system that supports as organization/ entity as it moves beyond basic collections of payments. It enables a fluid mix of collections and payments benefits that gives the entity freedom to manage different revenue and cost streams.

It has a number of unique capabilities that it can offer in the management of the OpenIMIS project and other entities that work with it.

From the initial architecture that has been shared by the openIMIS developer committee, the Mifos X system offers the following capabilities;

Premium Collection & Accounting Capabilities
Notification management capabilities
Claims Payment Management Capabilities
Cash disbursement capabilities
Pool funds Management capabilities.

The most important measure of success for an Insurance company/payer is successful collection of premiums and payments to suppliers for services rendered. The flexible architecture of Mifos X allows various ways of measuring this progress.

Mifos Architecture in the openIMIS deployment

Process Flows - Account Management / Crediting Accounts with Money

Process flows - Payments to Providers

Development

Mifos has no inbuilt payment capability. All current solutions involve building an interface or system that sits between it and banks/merchants/mobile network operators.

The de-facto payment gateway for Mifos is Mojaloop, (Mifos and Mojaloop – an End to End Open Source Architecture for Digital Financial Services – Mifos Initiative.)

Others are built by individuals and are only supported by the developer themselves and are

Given the high level of support and development, it is both efficient effective to implement Mifos Architecture when compared to Mifos Architecture 2 (Fig 1 as opposed to Fig 2 above).

Account Rules

Rules and policies that can be customized based on the products

1. Account Management

Newly created account will remain in-active until its approved
All Approved accounts are considered active Accounts
Active accounts can be attached to multiple products (Products are Savings, Fixed deposit, loan, current)
Active accounts can be debited or Credited (However rules can be customised based on the account type)
Single account can be attached to Multiple dependents
Disabled accounts cannot transact. Need to be enabled 1st

2. Collections & Payments

All accounts within the same office can be treated as a pool account
All accounts within a group can also be treated as a pool account
You cannot debit or credit a pool account. Only individual accounts can be debited or credited
Account number must be provided for all transactions
Overdraws are allowed based on some set of rules which are pre-defined

3. Account Query

for account status
For account details
For account balance
statement of account
last transaction/activity
last activity

Example

Use Case

The following scenario and subsequent entries shows the accounting treatment for an insurance company:

In January 2020, the Kinoti family takes a medical insurance cover for a total KShs 1 million, shared by the five family members.
Maternity is capped at KShs 100,000, while optical capped at KShs 5,000 per instance but no dental.
The cover costs the family KShs 30,000
On 15 March 2020, their first born is admitted to hospital and discharged 5 days later, for an approved cost of KShs 79,650.
On July 4, they are blessed with a new baby, they are discharged on July 10 at a cost of KShs 125,753.
On October 23, Mr. Kinoti gets prescription glasses at a total cost of KShs 7,500. He paid the excess immediately
In November, the second born gets dental work and braces at a cost of KShs 12,380.
They cancel the cover on 1 December 2020.

Insurance Accounting Entries

The following shows the accounting treatments for an insurance company:

On inception of the cover

		Account	Location	Amount	Amount
Dr		Insurance premium receivables	BS	30,000
	Cr	Insurance premium income	P&L		30,000

On payment of the insurance premium

		Account	Location	Amount	Amount
Dr		Bank	BS	30,000
	Cr	Insurance premium receivables			30,000

On receipt of the first born's claim

		Account	Location	Amount	Amount
Dr		Kinoti Family Shared Account	BS	79,650
	Cr	Gertrude Children's Hospital	BS		79,650

On approval of the first born's claim

		Account	Location	Amount	Amount
Dr		Medical claim	P&L	79,650
	Dr	Kinoti Family Shared Account	BS		79,650

On payment of the first born's claim

		Account	Location	Amount	Amount
Dr		Gertrude Children's Hospital	BS	79,650
	Cr	Bank	BS		79,650

On receipt of the fourth born's birth claim

		Account	Location	Amount	Amount
Dr		Kinoti Family Shared Account	BS	123,753
	Cr	The Nairobi Hospital	BS		123,753

On approval of the fourth born's claim

		Account	Location	Amount	Amount
Dr		Medical claim	P&L	100,000
	Cr	Kinoti Family Shared Account	BS		100,000

On receipt of the excess claim on fourth born

		Account	Location	Amount	Amount
Dr		Bank	BS	23,753
	Cr	Kinoti Family Shared Account	BS		23,753

On payment of the fourth born's claim

		Account	Location	Amount	Amount
Dr		Gertrude Children's Hospital	BS	123,753
	Cr	Bank	BS		123,753

On receipt of Mr. Kinoti's claim

		Account	Location	Amount	Amount
Dr		Kinoti Family Shared Account	BS	5,000
	Cr	Kikuyu Eye Hospital	BS		5,000

On approval of Mr Kinoti's claim

		Account	Location	Amount	Amount
Dr		Medical claim	P&L	5,000
	Cr	Kinoti Family Shared Account	BS		5,000

On approval of Mr Kinoti's claim (No entries for the dental work done on the second born)

		Account	Location	Amount	Amount
Dr		Kikuyu Eye Hospital	BS	5,000
	Cr	Bank	BS		5,000

Depending of the terms and conditions of the insurance cover, if the cover is time dependent, a refund for a month is due

		Account	Location	Amount	Amount
Dr		Insurance premium income	P&L	2,500
	Cr	Insurance premium refundable	BS		2,500

On payment of refund

		Account	Location	Amount	Amount
Dr		Insurance premium refundable	BS	2,500
	Cr	Bank	BS		2,500

If the cover is not shared but everyone has their own limits or cover, then an individual’s accounts are created. But the entries are largely the same.

Screenshots for the Mifos X Product Demo

Figure 7: Account entries

Challenges with Mifos

Mifos X is a system that was created with a deposit taking financial institutions in mind. As such, one of the challenges encountered is creating the grouping for the different consumers of medical covers. There are some limitations with the current implementation, as any client/group is set up to either be making deposits for either a savings or loan product. We shall only map the Scheme accounts and Payer accounts.

A second challenge is how the products exist in Mifos X. Normal insurance products usually expire annually without any carry over (other than refunds that or excesses that should be made good, but in either case, these can be handled off the within the actual accounting system). The medical insurance cover will be managed by OpenIMIS.

Mifos X is also not able to maintain information on the extent that beneficiaries have used their cover. This could cut across benefits limits for the various treatments offered ([Outpatient which can be split into general, dental, optical] and inpatient which can include maternity, surgeries]). OpenIMIS to manage this information and also the controls.

Integration with Mojaloop

Mifos vs MojaLoop – OpenIMIS Platform.

Mifos API Links

#	Category	Api Name	Description	Link
1	Account Management	Create Client	Creates an individual Account
		Activate Client	Activates and account
		Close Client	De-activate an account
		Reactivate Client	Re-activates a disabled account
		Client retrieve	Query account details
2	Account Transaction	Create a Savings	Create a account type (savings)	https://demo.mifos.io/api-docs/apiLive.htm#savingsaccounts_create
		Create a Fixed deposit	Create a account type (Fixed Deposit)
		Retrieve savings	Query for account type
		Withdrawal	Withdraw money from account
		Deposit	deposit money into an account

Ressources

Dockerised version

GitHub - mobidevke/mifos-docker: Mifos X docker stack

Deployed version

The End Points

Client Management API

https://mifos.s1.openimis.org/fineract-provider/api/v1/clients

Funds Deposit & Withdrawal

https://mifos.s1.openimis.org/fineract-provider/api/v1/savingsaccounts

General Ledger Management

https://mifos.s1.openimis.org/fineract-provider/api/v1/glaccounts

OpenIMIS FHIR4 Mapping

FHIR R4 - Patient
FHIR	Mifos
Patient Details	Client Details
Identifier	externalId
active	active
name	firstname
telecom	Mobile number
gender	Gender
birthDate	Date of Birth
deceased
address	Address Line
maritalStatus	Client Classification
photo	Picture
language	Language
generalPractitioner
managingOrganization	Office Details
link	Group ID
other
type	Group Name
contact	Family Details
relationship	Relationship
name	First name
telecom	Mobile Number
gender	Gender
organization	Profession
period	Date of Birth
	is Dependent
	Marital Status
	Number of members
	Number of dependents
	No of Children

Account Details	Account Details
	savingsProductId
	activationDate

FHIR R4 - Organization
FHIR	Mifos
Organization	Group Details
identifier	externalId
active	active
type
name	Name
alias
telecom	Group Activation Data
address	Address Details
part of
contact	staff
purpose
name	Staff Name
alias
telecom	Mobile number
address	Address Line
	Group Members
	clientMembers
	activationDate
	submittedOnDate

FHIR R4 - Claim-Payment
FHIR	Mifos
identifier	paymentTypeId
status	transactionStatus
request	ClientAccount
response
created	transactionDate
provider	GroupID
payment
paymentDate	transactionDate
payee	accountNumber
recipient	Office ID
amount	transactionAmount
paymentStatus	paymentStatus

FHIR R4-Contribution
FHIR	Mifos
identifier	paymentTypeId
status	transactionStatus
request
response
created	transactionDate
provider	savingsProductId
payment	transactionAmount
paymentDate	transactionDate
payee	accountNumber
recipient	accountNumber
amount	transactionAmount
paymentStatus

openIMIS

Payment Layer to Mifos X

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